Society Defies Courts With Offer Of `Exit Bag'

July 19, 1997|By DIANE C. LADE Staff Writer

For $40, Floridians can have what the Florida Supreme Court refused this week to grant them: an assisted death.

The next edition of Timelines, the 25,000-circulation newsletter for Hemlock Society USA, will feature an ad for Exit Bags. Instead of being aided by their doctors or families, the dying can mail-order a "self-deliverance" kit that includes instructions and a customized plastic bag.

The national organization, which promotes the right for the terminally ill to die on their own terms, thinks the Exit Bag will become a potent symbol as state legislatures and high courts continue to block assistance in dying.

"The plastic bag will become to physician-assisted suicide what the coat hanger was to abortion activists," said Faye Girsh, the Hemlock Society's executive director.

"We don't want people to have to die this way, but if they want to die, it's one of the better ways available," Girsh said. "I think there should be little signs printed [for the kit) that say, `I have resorted to this because I can't get help from my doctor.'''

Florida's first physician-assisted suicide case ended in defeat for AIDS patient Charles Hall on Thursday. The state Supreme Court ruled that Florida's constitutional privacy right did not permit Hall, a 35-year-old Central Florida man, to obtain a lethal overdose from his physician, Dr. Cecil McIver of Jupiter.

Now Hall, who decided to pursue his death through the courts after attending several local Hemlock meetings, probably will die in bed, heavily sedated with morphine, said his attorney, Robert Rivas.

Such scenes "breed a sense of rebellion among the people and tills the ground for flamboyant and flagrant practitioners like Jack Kevorkian," said Barbara Coombs Lee, executive director of Compassion in Dying. "It seems the courts are intent on keeping [assistance in dying) underground."

A $30 Exit Bag kit includes a sturdy clear plastic sack the size of a garbage bag, a soft elastic neckband and Velcro fasteners to ensure a snug fit. Another $10 buys a reprinted chapter from The Art of Science and Suicide, with detailed instructions and photographs showing how the Exit Bag can help readers achieve what the book calls "self-deliverance."

"This is a larger bag, so it's more comfortable and doesn't make you claustrophobic when you put it over your head," said Themmis Anno, a Toronto member of the Right to Die Society of Canada, which has sold the Exit Bag over the Internet for about a year and placed the Timelines ad. "Most people can fasten the closure without assistance. And the elastic band can be removed easily if you change your mind."

The society instructs the bag should be used solely as a backup method when taking a lethal drug overdose. Only buyers who say they are 21 or older can place orders.

But even Compassion, a Washington-based right-to-die group involved in one of the recent cases before the U.S. Supreme Court, draws the line at Exit Bags.

Instead, the group's volunteers sit with the dying and coach them to self-administer fatal overdoses, reducing the risk of a botched suicide that maims the patient.

Mary Bennett Hudson, president of Florida's Hemlock chapter, said she would encourage the dying to seek alternatives like hospice care and pain management before turning to Exit Bags. "It's very, very chancy and very difficult," she said.

Instead of shocking legislators and judges into a pro-assisted-death viewpoint, the vision of the dying shrouded in Exit Bags might disgust them into passing even tougher laws against those who help the terminally ill die, said bioethicist Ken Goodman.

"Finding a humane way of ending life is a real problem. And failure can mean real suffering," said Goodman, director of the Forum for Bioethics and Philosophy at the University of Miami. "How do you measure the adequacy of an Exit Bag? We can't even determine if the electric chair is painless."

Although 34 states have laws criminalizing assisting in a death, one health-care lawyer said Exit Bags probably are legal because they are just a means toward suicide and do not involve one person deliberately helping another person.

"You would have to prove specific intent, that one person guided another in suicide knowing the other person was susceptible," said Kathy Cerminara, a visiting professor at St. Thomas University Law School in Miami. "I would say a criminal conviction [for selling an Exit Bag through the mail) is not likely."

Death by bag is not a new phenomenon. Self-asphyxiation using common household plastic sacks like cleaning bags is one of the most common ways for elderly women to kill themselves, suicide studies have shown.

Hemlock co-founder Derek Humphry, in his 1991 self-help suicide classic Final Exit, advised self-deliverers to don a bag immediately after taking a lethal drug cocktail. Researchers analyzing 1,335 New York City suicides immediately before and after Final Exit was published found that while the suicide rate did not climb as expected, the number of bag-induced self-asphyxiations went from 8 to 33 percent.

The Canadian right-to-die society developed its bag after family members and survivors of botched Final Exit attempts complained the regular varieties were too weak, too difficult to secure solo and too stuffy. Exit Bags also take the guesswork out of the appropriate size.

"We had people call us, saying they needed to go the store and get a bag for someone who wanted to end their life, and they didn't know if they should buy a garbage-bag size or a turkey-bag size," Girsh said.